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Can we delineate preoperatively the right and ventral margins of caudate lobe of the liver?

Annals of Surgical Treatment and Research 2019년 97권 3호 p.124 ~ 129
 ( Shen Xue-Yin ) - Ajou University School of Medicine Department of Surgery

 ( Wang Hee-Jung ) - Ajou University School of Medicine Department of Surgery
 ( Kim Bong-Wan ) - Ajou University School of Medicine Department of Surgery
 ( Hong Sung-Yeon ) - Ajou University School of Medicine Department of Surgery
 ( Kim Mi-Na ) - Ajou University School of Medicine Department of Surgery
 ( Hu Xu-Guang ) - Jiangxi Cancer Hospital Department of Hepatobiliary Surgery

Abstract


Purpose: Complete removal of the caudate lobe, which is sometimes necessary, is accomplished via isolated caudate lobectomy or hepatectomy that includes the caudate lobe. It is impossible, however, to confirm the right and ventral margins of the caudate lobe by preoperative imaging. This study was undertaken to determine whether we could identify the right and ventral margins of the caudate lobe preoperatively using Synapse 3D visualization software.

Methods: Ninety-four preoperative 3-dimensional (3D) computed tomographic images (1-mm slices) of the liver from candidate donors were examined. The images of the caudate lobe were subjected to a counter-staining method according to Synapse 3D to delineate their dimensions. We first examined whether the right margin of the caudate lobe exceeded the plane formed by the root of the right hepatic vein (RHV) and the right side of the inferior vena cava (IVC). Second, we determined whether the ventral margin of the caudate lobe exceeded the plane formed by the root of the middle hepatic vein (MHV) and the root of the RHV.

Results: For the right margin, 17 cases (18%) exceeded the RHV-IVC plane by a mean of 10.2 mm (range, 2.4?27.2 mm). For the ventral margin, 28 cases (30%) exceeded the MHV-RHV plane by a mean of 17.4 mm (range, 1.2?49.1 mm).

Conclusion: Evaluating the anatomy of caudate lobe using Synapse 3D preoperatively could be helpful for more precise anatomical resection of the caudate lobe.

키워드

Caudate lobe of liver; Liver anatomy; Preoperative; Three-dimensional imaging
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